Hospitals slow to offer contraceptive option to patients

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NEW YORK — New York is poised to become the fourth state to require hospitals to offer emergency contraception to rape victims, but a campaign to extend the policy nationwide faces tough opposition. Particularly wary are Roman Catholic hospitals; their administrators worry that the requirements might in some cases conflict with their refusal to perform abortions.

Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

With Gov. George Pataki expected to sign a bill within days, New York will join California, Washington and New Mexico in requiring hospitals to provide access to emergency contraceptives. But bills pending in Congress that would impose the requirement nationally do not appear to be a priority for the Republican leadership.

“Our opponents try to frame this as an abortion issue, but it’s not — it’s a crime victims’ issue,” said Destiny Lopez, who lobbied for the New York bill on behalf of the state chapter of the National Abortion and Reproductive Rights Action League.

There are no national statistics on hospital policies regarding emergency contraceptives, but NARAL and its allies say surveys from several states indicate that fewer than half of all hospitals routinely offer the so-called morning-after pills to rape victims.

The Planned Parenthood Federation of America estimates that 300,000 U.S. women are sexually assaulted each year, with about 25,000 becoming pregnant as a result. More than 80 percent of these pregnancies could be prevented with use of emergency contraceptives, Planned Parenthood contends.

Compassionate care?
Although Catholic doctrine forbids the use of contraceptives in marital intercourse, Catholic hospitals are permitted to administer the morning-after pill to rape victims — but not if the medical staff determines that fertilization has already occurred.

The most common form of emergency contraception is a set of pills to be taken in two doses, 12 hours apart, as soon as possible after unprotected intercourse. They prevent fertilization — and are different from the abortion pill RU-486 — though Planned Parenthood says most American women know little about them.

The Rev. Michael Place, president of the Catholic Health Association, said the 600-plus hospitals under his purview strive to provide rape victims with “the full range of compassionate, effective medical care.”

However, he said, the advocacy groups pushing for mandatory emergency-contraception access were trying to force Catholic medical personnel to compromise their beliefs on abortion.

“They’re using a legitimate objective to pursue another agenda — to change the definition of when life begins,” Place said.

In New York, the Catholic hierarchy dropped its opposition to the bill after language was added allowing hospitals to withhold the contraceptive drugs from women who may have already become pregnant.

Once that happened, the bill sailed through, even winning unanimous backing in the Republican-controlled Senate after GOP leaders bought into the argument that it was not an abortion-rights measure.

“The women of New York will no longer face Russian roulette when they seek care after they’ve been raped,” family planning advocate JoAnn Smith said after the Senate vote.

Bills pending in Congress
Lopez said the bill marked a rare opportunity for abortion-rights advocates to find common ground with anti-abortion politicians.

“We all want to lower the abortion rate; with emergency contraception, this is our best chance to do it,” she said.

The bills pending in the U.S. House and Senate also have bipartisan support, but Rep. Jim Greenwood, R-Pa. — chief sponsor of the House measure — says winning passage will be “tough sledding.”

“The line between where abortion stops and family planning begins is always a close call when it comes to the House,” Greenwood said.

Bills similar to the New York measure were introduced in several other states this year, but few advanced out of committee. Hawaii lawmakers passed a bill, but Gov. Linda Lingle vetoed it out of concern that it would be challenged by Catholic hospitals.

The policy of offering emergency contraception to rape victims is endorsed by the American Medical Association and the American College of Obstetricians and Gynecologists. Yet supporters of the practice say that even many nonreligious hospitals fail to implement it.

“Sometimes it’s just a lack of education and training,” said Jennifer Nevins of the American Civil Liberties Union’s Reproductive Freedom Project.

Though groups like Planned Parenthood hope the Food and Drug Administration will soon allow emergency contraception to be obtained without a prescription, they say hospitals still should be required to offer them to rape victims.

“Once a woman has experienced the trauma of an assault, it’s not appropriate for a hospital to send her looking around for a pharmacy that’s open,” Nevins said.